Intensive Care Nurses' Knowledge on Quality of Care and Patient Safety

Purpose: To determine intensive care unit (ICU) nurses’ knowledge, attitudes, and perceptions of quality of care and patient safety.

Methods: A self-developed and validated questionnaire was used to evaluate nurses’ knowledge of key patient safety issues. The questionnaire was distributed and collected during the 2013 annual conference of the Flemish Society for Critical Care Nurses. Demographic data included gender, years of work experience, number of ICU beds, education, and whether respondents held an additional educational degree, and knew whether their hospital was currently running an accreditation trajectory.

Results: 625 Questionnaires (response rate 76.9%) were collected. The average score on the knowledge test was 42.2%. Twenty-eight percent of the respondents correctly estimated that 1-5% of hospitalized patients suffer preventable harm; 40% correctly estimated the probability of occurrence of medication errors; 39% and 38% respectively recognized the correct example of an active and latent error; and 41% knew that mainly inadequate processes are responsible for preventable patient harm. A quarter (24%) knew that calculation errors are the most frequently cause of medication errors in daily practice. Twenty-five% and 57% correctly identified characteristics of a positive safety culture. One third (34%) identified the different dimensions of quality care. Most nurses (97%) knew that hand hygiene is the most effective measure to prevent pathogen transmission between patients. Professional seniority was shown to be independently associated with lower knowledge levels. Those holding an additional educational degree had significant better test scores. Sixty-eight percent considered having sufficient knowledge to improve patient safety in their ICU.

Conclusion: Opportunities exist to improve ICU nurses’ knowledge on quality of care and patient safety based on a well-structured model and validated evidence. Further research may determine whether low scores are due to a lack of knowledge, deficiencies in education and/or training, differences in what is considered as good practice and/or an inappropriate policy in daily practice.